Cannabidiol (CBD) is generally considered safe to use, but there is always a risk of potential drug interactions. In some cases, people have reported increased seizures when consuming CBD. Therefore, it is important to consult with a professional before taking CBD as an anti-epileptic medication. Epidiolex, a pharmaceutical formulation of CBD, is approved by the FDA to treat three types of rare seizure disorders (Dravet syndrome, Lennox-Gastaut syndrome, and tuberous sclerosis complex).
However, it is not approved for many other types of epilepsy. Patients who have started taking CBD have reported significant improvements in their physical and psychological health, as well as reductions in anxiety and depression. Studies conducted with liver isoenzymes have shown that CBD can inhibit the activity of certain enzymes, such as CYP1A1, CYP1A2, CYP1B1, CYP2D6, CYP3A4 and CYP2C19. The most commonly reported adverse effects in randomized double-blind placebo-controlled trials with CBD compared to placebo in patients with Dravet syndrome were elevated levels of aminotransferases. After a 14-week period of treatment with CBD, 43% of patients had a reduction of at least 50% in the frequency of seizures. In addition, CBD levels have been found to increase with ketoconazole, a CYP3A4 inhibitor, but not with omeprazole, a CYP2C19 inhibitor. CBD has been shown to act on receptor 55 (GPR5) attached to the brain's G protein, which decreases the release of calcium in cells and reduces excitatory currents that can lead to seizures. The growing awareness that CBD is safer than THC and its potential anticonvulsant activity has led to the preferential use of whole plant preparations or liquid extracts or cannabis-based oils enriched with CBD content.
The review of available studies suggests that CBD-enriched cannabis may have anticonvulsant effects. However, more research is needed to confirm these findings. Overall, CBD appears to be effective as an adjunctive therapy in the treatment of drug-resistant infantile-onset epilepsy.
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